What Causes Gout?

"Gout is caused by an increase, or build up, of uric acid in the body.  It is usually a result of a decreased excreation of uric acid in our urine.  Initially the uric acid is found in the blood, but over time it will defuse throughout the body.  This includes the joints.  As uric acid increases in concentration in the joints it is more likely to crystallize.  These crystals can cause a lot of pain during an acute gout attack. 
 

The question can be asked: Why is gout usually seen in the feet?  Uric acid is not water soluble.  This means that it will crystallize if given the right conditions.  First, in high enough concentrations it can crystallize.  Second, as temperature decreases it is more likely to crystallize.  Gout can be found in any joint, but I believe it happens more in the feet because of the decreased temperature found in the feet.  The feet are the structures in the body that are furthest from the heart, making them the coolest. 

Symptoms of an acute gout attack include pain, edema (swelling), and erythema (redness) around the joint involved.  It is common to see a patient that was drinking alcohol or eating a steak dinner one evening to wake up the next morning with an acute gout attack.  The pain is usually 10 out of 10 and can be so painful it hurts to even let the bed sheets rest on the affected area.  An acute gout attack can mimic different arthritic conditions, including septic arthritis.  A diagnosis is made definitively through joint aspiration, which is then sent to a pathology lab."

- Dr. Marshal Gwynn

Foot Exams Help Prevent Ulcerations

diabetic foot syndrome

We urge all of our patients to make sure their primary-care physicians check their feet during every office visit for signs of ulcerations that, left untreated, can lead to infection and ultimately result in lower limb amputations.

It’s a simple exam that takes two minutes to determine if you are at risk for developing a foot ulcer. Perhaps the easiest way to remember to get your feet checked is to remove your shoes and socks in the examining room. Most diabetic patients are vulnerable to foot ulcerations caused by poor blood circulation in the lower extremities and neuropathy that inhibits nerve sensation.

Ulcers are the leading cause of foot amputations among people with diabetes, but they are preventable in most cases if doctors routinely check their patient’s feet.

In a routine foot exam we check for nerve sensation, skin irregularities (corns, calluses, punctures and areas of redness), swelling, drainage, and foot deformities that cause unnatural pressure points that are prone to ulceration.

Patients with diabetes who have their feet checked regularly can prevent foot ulcers or have them treated at early stages by their podiatrist.

Arnica Pain Relief

A couple days ago in our Blacksburg office, a patient mentioned to me a cream she has been using for pain. She mentioned it even helps with bruises! I had to immediately ask the name of the cream and she said it's called Arnica and she buys it at Annie Kay's Natural Food Store in Blacksburg, VA.

I know a woman that works over there and asked her to send me some information on it. Turns out it's a best seller item and all the employees swear by it! I love learning about new products from my patients.

Here is a bit more information about the pain relief cream:

• Reduces pain, swelling and discoloration from bruises
• Temporarily relieves muscle pain and stiffness due to minor injuries, overexertion and falls

If you'd like to learn more visit their website at: www.boiron.com

- Dr. Kate